A 69-year-old female presented with increasing shortness of breath (NYHA class II) and was previously followed for aneurysmal dilatation of her thoraco-abdominal aorta with a chronic type B aortic dissection. Repeat computed tomography (CT) demonstrated severe dilatation of her ascending aorta, aortic arch, descending aorta, and thoraco-abdominal aorta with the chronic type B aortic dissection extending from the proximal descending thoracic aorta to the renal arteries. Pre-operative transthoracic echocardiography revealed moderate central aortic insufficiency with a dilated aortic root and ascending aorta. Other past medical history included an ongoing 50-pack-year smoking history, chronic obstructive pulmonary disease, and remote cholecystectomy
